Depression can lead to emotional and physical problems. Typically, people with depression find it hard to go about their day-to-day activities, and may also feel that life is not worth living.
Depression can lead to emotional and physical problems. Typically, people with depression find it hard to go about their day-to-day activities, and may also feel that life is not worth living.
Feeling sad, or what we may call “depressed”, happens to all of us. The sensation usually passes after a while. However, people with a depressive disorder – clinical depression – find that their state interferes with daily life. Abraham Lincoln O-60 by Brady, 1862 Abraham Lincoln suffered from “melancholy”, known today as clinical depression.
For people with clinical depression, their normal functioning is undermined to such an extent that both they and those who care about them are affected by it.
Hippocrates, known as the father of Western medicine, described a syndrome of “melancholia”. He said melancholia was a distinct disease with specific physical and mental symptoms. Hippocrates characterized it as “(all) fears and despondencies if they last a long time” as being symptomatic of the illness.
According to the National Institutes of Health, a significant percentage of people with a depressive illness never seek medical help. This is unfortunate because the vast majority, even those with very severe symptoms, can improve with treatment.
A depressive disorder is a medical illness that causes a constant feeling of sadness and lack of interest.
The notion that depression is simply a “chemical imbalance” in the brain has given way to evidence that the disorder is associated with
In short depression is truly a Brain Disease and its treatment should be multimodal to better allow those suffering from it to have their wellness restored, quality of life restored and functional capacity be fully realized. At The TMS Center of Southwest Florida we TMS as our primary treatment in treating the “Brain” illnesses our patients are suffering from.
Depression is not uniform. Signs and symptoms may be experienced by some sufferers and not by others. How severe the symptoms are, and how long they last depend on the individual person and his illness. Below is a list of the most common symptoms:
There are several forms of depression (depressive disorders). Major depressive disorder and dysthymic disorder are the most common.
Major depressive disorder (major depression)
Major depressive disorder is also known as major depression. The patients suffer from a combination of symptoms that undermine their ability to sleep, study, work, eat, and enjoy activities they used to find pleasurable.
Experts say that major depressive disorder can be very disabling, preventing the patient from functioning normally. Some people experience only one episode while others have recurrences.
Dysthymic disorder (dysthymia)
Dysthymic disorder is also known as dysthymia or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. The symptoms are not as severe as in major depression – they do not disable the patient. However, people affected with dysthymic disorder may find it hard to function normally and feel well.
Some people experience only one episode during their lifetime while others may have recurrences.
When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression. Psychotic depression is also referred to as delusional depression.
Postpartum depression (postnatal depression)
Postpartum depression is also known as postnatal depression or PND. This is not to be confused with ‘baby blues’ which a mother may feel for a very short period after giving birth.
If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed postpartum depression.
SAD (seasonal affective disorder)
SAD is much more common the further from the equator you go, where the end of summer means the beginning of less sunlight and more dark hours. A person who develops a depressive illness during the winter months might have SAD.
Bipolar disorder (manic-depressive illness)
Bipolar disorder is also known as manic-depressive illness. It used to be known as manic depression. It is not as common as major depression or dysthymia. A patient with bipolar disorder experiences moments of extreme highs and extreme lows. These extremes are known as manias.
Nobody is sure what causes depression. Experts say depression is caused by a combination of factors, such as the person’s genes, their biochemical environment, personal experience and psychological factors.
A study published in Archives of Psychiatry found that MRI (magnetic resonance imaging) scans showed patients with clinical depression had less brain volume in several regions, including the frontal lobe, basal ganglia, and hippocampus. They also found that after treatment the hippocampus returned to normal size.
The Stanford School of Medicine says that genes do play a role in causing depression. By studying cases of major depression among identical twins (whose genes are 100% identical) and non-identical twins (whose genes are 50% identical) they found that heritability is a major contributory factor in the risk of developing depression.
An article in Harvard Health Publications explains that depression is not caused simply by the level of one chemical being too low and another too high. Rather, several different chemicals are involved, working both within and outside nerve cells. There are “Millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life.”
An awful experience can trigger a depressive illness. For example, the loss of a family member, a difficult relationship, physical sexual abuse.
Virginia Beach, Va. – Rana Culotta Simpson has suffered from depression most of her adult life. “I would sleep three days, at times 2-3 days not getting out of the bed,” says Culotta. This made it hard for the 35-year-old Peninsula resident to keep her job as a newspaper reporter. “I was socially anxious. I was phobic, paranoid. It was very hard to focus,” says Culotta. She`d tried antidepressants, but she wasn`t getting better. Eventually, she was placed on work disability. Then she found Dr. Katharine Heatwole at Ocean Psychiatric Group in Virginia Beach. It’s one of only 2 or 3 clinics in Hampton Roads treating patients with transcranial magnetic stimulation or TMS. “It’s pulse magnetic energy to the front left part of the brain, and that stimulates a little electrical current to the neurons or brain cells,” says Dr. Heatwole. “During my 1st treatment, I actually felt like there was someone tinkering or tapping on my head,” says Culotta. “That has a stimulation effect on the mood circuit so that it releases the neurotransmitters that are involved in mood,” says Culotta. “It is based on neuroplasticity and training the neurons to do what they are supposed to do in […]
By the time she was 61, Martha Rhodes had spent decades battling intractable depression. Diagnosis: treatment-resistant major depressive disorder. She’d tried a variety of medications to no avail; most were ineffective or caused nausea, diarrhea, weight gain and mood swings. During one particularly low evening in 2009, she attempted suicide. And every morning when she awoke, she experienced what she describes as “an emotional nausea – it was like this feeling of, ‘Why am I still here? Why do I have to be alive?’” But four years ago, Rhodes, now 65, of Danbury, Connecticut, underwent a procedure she says saved her life: repetitive transcranial magnetic stimulation, which uses magnetic pulses to electrically stimulate nerve cells in the brain and is used by doctors to relieve symptoms of depression. “My feelings of hopelessness, wishing I were dead and that life wasn’t worth living – all of that went away,” recalls Rhodes, who chronicled her experience with TMS in her 2013 book “3,000 Pulses Later.” Rhodes says she shares her story with others to demystify the treatment – which is often misunderstood by both patients and doctors, though it’s increasingly used by medical practitioners nationwide. What Is TMS? TMS was first developed […]
When you’re depressed, literally and figuratively stuck in a dark place, with no desire to get out and experience the world, it feels like time is inching by. Seconds feel like minutes, minutes feel like hours, and hours feel like days. Apparently, though, it’s not just a feeling. It’s a very real perception of time. New research from psychologists at the Johannes Gutenberg University of Mainz in Germany shows that depressed people actually experience time differently than healthy individuals. The scientists analyzed the results of 16 different studies examining 433 depressed subjects and 485 non-depressed control subjects. For the first part of the study, subjects were surveyed on their perception of time. “Psychiatrists and psychologists in hospitals and private practices repeatedly report that depressed patients feel that time only creeps forward slowly or is passing in slow motion,” reported study author Dr. Daniel Oberfeld-Twistel. The results of the meta-analysis confirmed that this is indeed the case. Then, for the second part of the study, they asked the subjects to subjectively estimate the length of a movie in minutes, press a button for five seconds, or identify the length of different sounds. In this case, the results obtained from the depressed […]
BY NEWSWEEK SPECIAL EDITION ON 4/2/17 AT 2:10 PM This article is featured in Newsweek’s Special Edition: Nature’s Remedies—Heal Your Body. One of the leading causes of disability in the United States isn’t physical—it’s mental. According to the Anxiety and Depression Association of America (ADAA), 15 million adults—approximately 6.7 percent of the population—suffer from major depressive disorder, which is most often treated through a combination of talk therapy and medication. Those who struggle with depression have imbalanced levels of serotonin, which maintains mood, and dopamine, which controls the pleasure and reward zones. The brain’s synapses control how much of these chemicals are released, and drugs like Zoloft effectively prevent the little serotonin being produced from reabsorbing back into the nerve cells from which they were released, resulting in a higher concentration of serotonin. Some pill-averse patients have longed for a natural cure for depression, while others complain that the drugs they’re on aren’t enough. Hope for both groups may have arrived through an unlikely source: magnets. Researchers discovered they can harness the power of magnetism to increase serotonin production and combat depression through a process called Transcranial Magnetic Stimulation (TMS). “Each [symptom of depression] maps onto a given circuit of the brain,” […]
Analysis of FAERS data finds less comorbid depression among pain patients on ketamine by Neel A. Duggal Contributing Writer, MedPage TodayMay 12, 2017 An analysis of data from the FDA Adverse Events Reporting System (FAERS) supported previous findings that ketamine could be an effective treatment for depression, researchers found. Given financial and ethical obstacles to a large randomized controlled trial of ketamine for depressive disorders, Ruben Abagyan, PhD, of the University of California San Diego, and colleagues decided to turn to AERS data on patients taking ketamine for pain, an FDA-approved use. They found that patients who took ketamine had significantly lower frequency of reports of depression than those taking any other drugs for pain, according to findings published in Scientific Reports. “This reduction in depression is specific to ketamine and is known to be much more rapid than current antidepressants, making this observed effect very promising for treatment of patients with acute depressive or suicidal episodes,” Abagyan and colleagues wrote. [Read the Full Article Here]
Friday, May 05, 2017 Lisa Salmon Have you heard of TMS? It stands for transcranial magnetic stimulation and, according to reports, could offer hope to people with clinical depression when other treatments haven’t helped. It was invented in Sheffield the 1980s and has been used to treat a number of mental and physical health conditions, including OCD, anorexia, tinnitus and fibromyalgia — but studies suggest up to 70% of people with clinical depression could benefit from it. Treatments usually centre around talking therapies, such as cognitive behavioural therapy (CBT) and antidepressant medicines. For severe depression that hasn’t improved with other treatments, electroconvulsive therapy (ECT), where an electric current is applied to the brain under general anaesthetic, is sometimes used. “TMS is a much more acceptable intermediary treatment between medication and ECT,” says consultant psychiatrist Dr Leigh Neal, medical director of the Smart TMS clinic in London. “It involves a sea change of how we’ll treat people in the future and the outcomes for depression.” HOW DOES IT WORK? TMS simply involves a magnetic head, which converts electricity into a magnetic field, being placed against the scalp. The magnetic field sets up electrical circuits in the brain, affecting only a tiny […]
Thetaburst Stimulation in 2017 This article from 2015 published by CTV News gives a good overview of TBS Stimulation and the exciting effect the treatment was having on patients with depression. Now, in 2017, the TMS Center of Southwest Florida is thrilled to offer both TMS and TBS treatment options for our patients. For more information please call: 888-491-4171. * * * * * * * * * * * Jesse Tahirali, CTVNews.ca Published Sunday, January 25, 2015 10:10PM EST The grey clouds of depression are difficult to shake. Approximately eight per cent of Canadian adults will experience a major depression at some point in their lives, according to Toronto’s Centre for Addiction and Mental Health. Medication often fails to temper the debilitating effects of the illness. Only one third of patients report improvement after their first round of treatment, and some fail to improve regardless of what they’re prescribed. Gail Bellissimo, a Mississauga mother of four, was one of those people who still suffer even after seeking help. “I tried just about every drug out there, antidepressant of all kinds,” Bellissimo said. “They just either didn’t work for me or the side effects were too much for me to take.” […]
John Foster, like many who have served our country, has dealt with the lasting effects of war, especially post-traumatic stress disorder (PTSD). The 38-year-old says a genetic test, ordered by his doctor, helped guide his treatment plan and allowed him to get better, faster. The Orlando, Florida, resident was a combat medic and served two tours of duty in Iraq. He says the first tour, in 2004 and 2005, left him with no problems…or so he thought. It was during the second tour, in 2006 and 2007, when his issues developed. This is when the Army extended tours as a part of the troop surge. During John’s deployment, 11 members of his unit were killed in the deadliest year of the war on terror. Foster’s PTSD has required both inpatient and outpatient treatment. Through the years, he’s dealt with the frustration of discovering that many psychiatric drugs don’t work for him: at one point taking as many as 13 different medications a day. “My doctor, Dr. Robert Pollack, was able to adjust my meds and recommend supplements to more effectively help me deal with the situation…the Genecept Assay® was key for me to help unlock the personal information that I […]
Question: How do effects of genetics and rearing each contribute to the transmission of risk for major depression from parents to children? Findings: In this population register–based study of 2 269 552 offspring of intact, adoptive, not-lived-with father, stepfather, and triparental families from the general Swedish population, the effects of genes and rearing were approximately equal for parent-offspring resemblance for major depression. Genetic and rearing effects acted additively on offspring risk for major depression. Meaning: Genetic and rearing effects are important in the cross-generational transmission of major depression. Importance Twin studies have assessed sibling resemblance for major depression (MD) but cannot address sources of resemblance across generations. Objective To clarify the relative importance of genetic and rearing effects on the parent-offspring resemblance for MD. Design This Swedish population register–based study examined parents and children from the following 5 family types: intact (2 041 816 offspring), adoptive (14 104 offspring), not-lived-with (NLW) father (116 601 offspring), stepfather (67 826 offspring), and triparental (29 205 offspring). The 5 family types permitted quantification of parent-offspring resemblance for genes plus rearing, genes-only, and rearing-only associations. Treated MD was assessed from national primary care, specialist care, and inpatient registries. Data were collected from January 1, 1960, through […]
Ketamine, which has been called “the most important discovery in half a century,” just got a step closer to becoming the first new depression drug in 35 years. Johnson & Johnson, one of the pharmaceutical companies pursuing the drug’s fast-acting antidepressant qualities, presented some promising new research on Saturday that could raise the drug’s profile as a potential treatment for the condition. It’s a dramatic departure for a compound that most people know either as a surgical anesthetic or a party drug. And it’s a seemingly welcome one, according to physicians and psychiatrists who say they’ve grown tired of giving patients the same mediocre drugs for the past four decades. Johnson & Johnson isn’t the only drugmaker that’s hot on the ketamine trail. Allergan is in the last phase of clinical trials with a drug that acts on the same receptor as ketamine, and San Francisco drugmaker VistaGen is studying a similar ketamine-inspired drug. J&J’s version of ketamine is a nasal spray made with a compound called esketamine, the chemical mirror image of ketamine. In its latest clinical trial, the company’s neuroscience partner, Janssen Research, wanted to show that the spray was safe, well tolerated, and superior to both a placebo and a traditional antidepressant. To do it, the researchers had […]
Significance Identifying biological targets in major depressive disorder (MDD) is a critical step for development of effective mechanism-based medications. The epigenetic agent acetyl-L-carnitine (LAC) has rapid and enduring antidepressant-like effects in LAC-deficient rodents. Here, we found that LAC levels were decreased in patients with MDD versus age- and sex-matched healthy controls in two independent study centers. In subsequent exploratory analyses, the degree of LAC deficiency reflected both the severity and age of onset of MDD. Furthermore, the lowest LAC levels were found in patients with treatment-resistant depression, whereby history of emotional neglect and being female predicted decreased LAC levels. These translational findings suggest that LAC may serve as a candidate biomarker to help the diagnosis of a clinical endophenotype of MDD. Abstract The lack of biomarkers to identify target populations greatly limits the promise of precision medicine for major depressive disorder (MDD), a primary cause of ill health and disability. The endogenously produced molecule acetyl-L-carnitine (LAC) is critical for hippocampal function and several behavioral domains. In rodents with depressive-like traits, LAC levels are markedly decreased and signal abnormal hippocampal glutamatergic function and dendritic plasticity. LAC supplementation induces rapid and lasting antidepressant-like effects via epigenetic mechanisms of histone acetylation. This mechanistic […]